Integration of the metabolic data of positron emission tomography in the dosimetry planning of radiosurgery with the Leksell gamma knife: early experience with brain tumors

Technical note

Marc LevivierGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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David WikierGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Serge GoldmanGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Philippe DavidGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Thierry MetensGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Nicolas MassagerGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Massimo GerosaGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Daniel DevriendtGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Françoise DesmedtGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Stephane SimonGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Paul Van HoutteGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Jacques BrotchiGamma Knife Center of the Université Libre de Bruxelles; Departments of Neurosurgery, PET/Biomedical Cyclotron, and Neuroradiology, Hôpital Erasme; and Department of Radiation Therapy—Laboratory of Physics, Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium

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Page Range:
233–238
Volume/Issue:
Volume 93: Issue supplement_3
DOI link:
https://doi.org/10.3171/jns.2000.93.supplement_3.0233
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✓ The purpose of this study was to assess the use of positron emission tomography (PET) as a stereotactic planning modality for gamma knife radiosurgery (GKS).

The authors developed and validated a technique for fiducial marker imaging, importation, and handling of PET data for integration into GammaPlan planning software. The clinical feasibility in applying this approach to a selected group of patients presenting with recurrent glial tumors or metastases was evaluated.

Positron emission tomography data can be integrated into GammaPlan, allowing a high spatial accuracy, as validated using a phantom. Positron emission tomography data were successfully combined with magnetic resonance (MR) images to define the target volume for the radiosurgical treatment of patients with recurrent glioma or metastasis. This approach may contribute to optimizing target selection for infiltrating or ill-defined brain lesions. Because PET is also useful for the pretreatment and follow-up evaluation, the use of stereotactic PET in these patients can enable an accurate comparison of PET-based metabolic data with MR-based anatomical data. This could give a better understanding of the metabolic changes following radiosurgery.

The ability to use PET data in GKS represents a crucial step toward further developments in radiosurgery, as this approach provides additional information that may open new perspectives for the optimization of the treatment of brain tumors.

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Contributor Notes

Address reprint requests to: Marc Levivier, M.D., Ph.D., Department of Neurosurgery and Gamma Knife Center, U.L.B. Hôpital Erasme, 808 rue de Lennik, B-1070 Brussels, Belgium. email: Marc.Levivier@ulb.ac.be.
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